OBJECTIVE While positional nystagmus of benign paroxysmal positional vertigo (BPPV) has been shown to be detectable in electrooculography (EOG) tracings of polysomnography (PSG), the frequency of undiagnosed BPPV in patients referred for sleep-wake examination has never been investigated. METHODS Prospective evaluation of positional nystagmus in 129 patients, referred to a neurological sleep laboratory for sleep-wake examination with PSG. Both in the evening and morning, patients had diagnostic positioning maneuvers under ongoing EOG-PSG registration, followed by visual inspection of EOG for positional nystagmus. RESULTS In 19 patients (14.7%), we found patterns of positional nystagmus, typically appearing few seconds after changes in head position. In 9 of these patients (47%), the nystagmus was also provoked by the positioning maneuvers. Nystagmus only occurred during wakefulness, not during sleep. In a patient with severe cupulolithiasis, we observed disappearance of nystagmus while entering N1 sleep stage. Nocturnal positional nystagmus was independently associated with positive positioning maneuvers. CONCLUSIONS Inspection of EOG-PSG demonstrated that positional nystagmus is common, occurring only when wake, and independently associated with positive positioning maneuvers. SIGNIFICANCE By routinely searching for positional nystagmus in PSG, sleep physicians may substantially contribute to the identification of patients with so-far undiagnosed BPPV.

中文翻译：

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眼睛醒来：用多导睡眠图筛查良性阵发性位置性眩晕

目的 虽然良性阵发性位置性眩晕 (BPPV) 的位置性眼球震颤已被证明可在多导睡眠图 (PSG) 的眼电图 (EOG) 追踪中检测到，但从未对转诊进行睡眠-觉醒检查的患者中未确诊 BPPV 的频率进行调查。方法前瞻性评估 129 名患者的位置性眼球震颤，转诊至神经睡眠实验室进行 PSG 睡眠-觉醒检查。在晚上和早上，患者在正在进行的 EOG-PSG 登记下进行诊断性定位操作，然后目视检查 EOG 是否存在位置性眼球震颤。结果 在 19 名患者 (14.7%) 中，我们发现了位置性眼球震颤的模式，通常在头部位置改变后几秒钟出现。在这些患者中的 9 名 (47%) 中，眼球震颤也是由定位操作引起​​的。眼球震颤只发生在清醒时，而不是在睡眠时。在患有严重杯石症的患者中，我们观察到在进入 N1 睡眠阶段时眼球震颤消失。夜间位置性眼球震颤与正向定位操作独立相关。结论 EOG-PSG 检查表明位置性眼球震颤很常见，仅在清醒时发生，并且与正向定位操作独立相关。意义 通过常规搜索 PSG 中的位置性眼球震颤，睡眠医生可能会极大地帮助识别迄今为止尚未确诊的 BPPV 患者。夜间位置性眼球震颤与正向定位操作独立相关。结论 EOG-PSG 检查表明位置性眼球震颤很常见，仅在清醒时发生，并且与正向定位操作独立相关。意义 通过常规搜索 PSG 中的位置性眼球震颤，睡眠医生可能会极大地帮助识别迄今为止尚未确诊的 BPPV 患者。夜间位置性眼球震颤与正向定位操作独立相关。结论 EOG-PSG 检查表明位置性眼球震颤很常见，仅在清醒时发生，并且与正向定位操作独立相关。意义 通过常规搜索 PSG 中的位置性眼球震颤，睡眠医生可能会极大地帮助识别迄今为止尚未确诊的 BPPV 患者。